Cardiopulmonary bypass: Difference between revisions

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= Cardiopulmonary Bypass =
{{Infobox medical procedure
| name = Cardiopulmonary Bypass
| image = Blausen 0468 Heart-Lung Machine.png
| caption = Diagram of a heart-lung machine used in cardiopulmonary bypass
| ICD10 = 5A1221Z
| ICD9 = 39.61
}}


Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during cardiac surgery, maintaining the circulation of blood and the oxygenation of the body. This process is facilitated by a heart-lung machine, allowing surgeons to perform intricate procedures on the heart while it is stopped.
'''Cardiopulmonary bypass''' (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump is often referred to as a "heart-lung machine" or "the pump".


[[File:Heart-lung bypass.jpg|thumb|500px|A heart-lung machine used during cardiopulmonary bypass surgery.]]
==History==
The development of cardiopulmonary bypass was a significant milestone in cardiac surgery. The first successful use of a heart-lung machine was in 1953 by Dr. John Gibbon, who used it to perform an open-heart surgery. The machine has since evolved significantly, with improvements in safety and efficiency.


== Purpose ==
[[File:1955 heart lung machine.jpg|thumb|Early heart-lung machine from 1955]]
The primary purpose of cardiopulmonary bypass is to provide a bloodless field and a motionless heart for the surgeon to perform precise and complex surgical procedures on the heart, such as coronary artery bypass grafting (CABG), heart valve repair or replacement, and congenital heart defect correction.


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==Components==
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The main components of a cardiopulmonary bypass machine include:
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== Components ==
* '''Oxygenator''': This component adds oxygen to the blood and removes carbon dioxide, mimicking the gas exchange function of the lungs.
The CPB circuit consists of several key components:
* '''Pump''': The pump circulates the blood through the body, replacing the pumping action of the heart.
- '''Oxygenator''': Replaces the gas exchange function of the lungs by adding oxygen to the blood and removing carbon dioxide.
* '''Heat exchanger''': This allows the surgical team to control the temperature of the blood, which can be important for certain procedures.
- '''Pump''': Acts as the heart by propelling blood through the circuit and back into the body.
* '''Filters''': These remove air bubbles and other debris from the blood to prevent embolism.
- '''Heat Exchanger''': Controls the temperature of the blood, allowing for hypothermia or normothermia as required by the surgical procedure.
- '''Filters''': Remove air bubbles and particulate matter from the blood to prevent embolism.


== Process ==
==Procedure==
The process of cardiopulmonary bypass involves:
During cardiopulmonary bypass, the patient's blood is diverted from the heart and lungs to the heart-lung machine. The machine oxygenates the blood and returns it to the body, allowing the surgeon to operate on a still and bloodless heart.
1. Cannulation, where tubes are inserted into the heart or great vessels to divert blood away from the heart to the heart-lung machine.
2. Initiation of CPB, where blood is oxygenated and circulated by the machine, bypassing the heart and lungs.
3. Maintenance of physiological parameters, including blood pressure, oxygen and carbon dioxide levels, and body temperature, throughout the surgery.
4. Weaning off CPB, gradually transferring the circulatory and respiratory functions back to the patient's heart and lungs.


== Risks and Complications ==
[[File:Perfusionist opearting heart lung machine.jpg|thumb|A perfusionist operating a heart-lung machine]]
While CPB is a lifesaving procedure, it is associated with several potential risks and complications, including:
- Systemic inflammation response syndrome (SIRS)
- Coagulation disorders
- Neurological complications, including stroke and cognitive deficits
- Organ dysfunction, such as renal failure or pulmonary complications


== Advancements ==
==Applications==
Recent advancements in cardiopulmonary bypass technology focus on minimizing the adverse effects associated with CPB. These include the development of miniaturized CPB circuits, which reduce the amount of blood contact with foreign surfaces, and techniques for reducing inflammation and organ dysfunction.
Cardiopulmonary bypass is primarily used in [[open-heart surgery]], such as coronary artery bypass grafting (CABG), heart valve repair or replacement, and heart transplant surgeries.


== External Links ==
[[File:Coronary artery bypass surgery Image 657C-PH.jpg|thumb|Coronary artery bypass surgery]]
* [https://www.sts.org/patient-information/cardiovascular-conditions-procedures/cardiac-surgery-and-cardiopulmonary-bypass The Society of Thoracic Surgeons - Cardiac Surgery and Cardiopulmonary Bypass]
* [https://www.aha.org/cardiovascular-disease American Heart Association - Cardiovascular Disease]


== References ==
==Risks and Complications==
<references />
While CPB is generally safe, it can be associated with complications such as:
 
* '''Bleeding''': Due to anticoagulation required during the procedure.
* '''Stroke''': From air embolism or debris.
* '''Inflammatory response''': Triggered by the contact of blood with the artificial surfaces of the machine.
 
==Also see==
* [[Coronary artery bypass surgery]]
* [[Heart valve surgery]]
* [[Perfusionist]]
* [[Open-heart surgery]]
 
{{Cardiac surgery}}
{{Cardiology}}


[[Category:Cardiac surgery]]
[[Category:Cardiac surgery]]
[[Category:Medical procedures]]
[[Category:Medical equipment]]
 
{{stub}}

Latest revision as of 02:48, 11 December 2024
Diagram of a heart-lung machine used in cardiopulmonary bypass
Pronunciation
Other names
Specialty
Uses
Complications
Approach
Types
Recovery time
Other options
Frequency



Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump is often referred to as a "heart-lung machine" or "the pump".

History[edit]

The development of cardiopulmonary bypass was a significant milestone in cardiac surgery. The first successful use of a heart-lung machine was in 1953 by Dr. John Gibbon, who used it to perform an open-heart surgery. The machine has since evolved significantly, with improvements in safety and efficiency.

Early heart-lung machine from 1955

Components[edit]

The main components of a cardiopulmonary bypass machine include:

  • Oxygenator: This component adds oxygen to the blood and removes carbon dioxide, mimicking the gas exchange function of the lungs.
  • Pump: The pump circulates the blood through the body, replacing the pumping action of the heart.
  • Heat exchanger: This allows the surgical team to control the temperature of the blood, which can be important for certain procedures.
  • Filters: These remove air bubbles and other debris from the blood to prevent embolism.

Procedure[edit]

During cardiopulmonary bypass, the patient's blood is diverted from the heart and lungs to the heart-lung machine. The machine oxygenates the blood and returns it to the body, allowing the surgeon to operate on a still and bloodless heart.

A perfusionist operating a heart-lung machine

Applications[edit]

Cardiopulmonary bypass is primarily used in open-heart surgery, such as coronary artery bypass grafting (CABG), heart valve repair or replacement, and heart transplant surgeries.

Coronary artery bypass surgery

Risks and Complications[edit]

While CPB is generally safe, it can be associated with complications such as:

  • Bleeding: Due to anticoagulation required during the procedure.
  • Stroke: From air embolism or debris.
  • Inflammatory response: Triggered by the contact of blood with the artificial surfaces of the machine.

Also see[edit]


Tests and procedures involving the heart
Surgery
Heart valves
and septa
* Valve repair
production of septal defect in heart
enlargement of existing septal defect
Atrial septostomy
Balloon septostomy
creation of septal defect in heart
Blalock–Hanlon procedure
shunt from heart chamber to blood vessel
atrium to pulmonary artery
Fontan procedure
left ventricle to aorta
Rastelli procedure
right ventricle to pulmonary artery
Sano shunt
compound procedures
for transposition of the great vessels
Arterial switch operation
Mustard procedure
Senning procedure
for univentricular defect
Norwood procedure
Kawashima procedure
shunt from blood vessel to blood vessel
systemic circulation to pulmonary artery shunt
Blalock–Taussig shunt
SVC to the right PA
Glenn procedure
Cardiac vessels
Other




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